From the beginning of this drama going on a month ago, the White House has been laser-focused on shutting down government-supported medical research in the United States. Of course, much of that is research into cancer cures or fundamental research building toward the same. The precise goal of all this shutting down is difficult to uncover — likely one half an effort to destroy or exercise control over academic/research institutions mixed with post-COVID hostility to medical research itself. On paper the effort was put on hold by a mix of the White House backing off and the original orders being blocked by judges. But in fact the White House has found very effective workarounds to evade the impact of those court orders. And that evasion, or those alternative paths to shutting down research grants, has accelerated or clamped down even harder this week.
I’m going to try to give a general outline of what’s happening. It’s difficult to describe all of it in detail: First, because a handful of different brakes are being applied at once and second, because figuring it out is largely the work of people on the receiving end trying to interpret what they’re seeing. When they’re on the disbursing end it can also be difficult to get a full picture because there are different disbursal arms. And the White House/DOGE etc. are taking various steps to reduce communication within NIH. Because of all that this post is one half informational and one half a call to others in the federal medical research grant ecosystem to share what they are seeing and add to the picture. (See above how to contact me by encrypted channels if you have confidential information.)
Let’s start by thinking of the medical research funding system as two pipes or processes. First is the channel of actual funds which is relatively straightforward in concept and is at least technically unfrozen after the disruptions earlier this month. Then there’s the approval pipe. This, as I understand it, is perhaps one half like a quasi-peer review process and one half like getting your home loan approved. Those are both necessary for quality control, reviewing the value, quality of the work and so forth and also necessary to legally disburse the money. That’s key: if a grant hasn’t gone through this approval process is not legal to disburse the money. So the money can be ready to go but the grant-making authority won’t approve it. It’s not frozen. It just doesn’t exist. Central to this process are what are called ‘Study Sections’, basically the central meetings in the approval process I just described. The White House has been using a host of tools to prevent those meetings from happening. So the administration can tell the judge they’ve unfrozen the money but so far no new grants are being approved. But the reason is that they’ve broken the grant approval process that the judicial process simply isn’t looking at.
Something like this has been going on all month. But at first it seemed more haphazard or perhaps it was less clear whether it was by design or simply the after effects of the breakage caused during the first days of the administration. Now however a new wrinkle has been added. Study Sections have to be recorded in the Federal Register in advance of the meetings. But now the White House is apparently requiring that the NIH go through the White House to post those notifications to the Federal Register. If they’re not posted to the Federal Register in the Study Sections can’t happen.
I was told by one source that Study Sections and thus grant approvals that were scheduled to take place in January just after the inauguration now won’t take place until May at the earliest. A new round of reviews and approvals which was being processed this month and were about to have their study sections take place were just canceled on short notice. I’m still trying to determine whether that cancelation was system-wide or just focused on one part of the grant approval system.
What I can say confidently is that the grant approval system which the courts believe they have unfrozen remains at least mainly frozen. The White House is likely not technically violating the court order though certainly they are evading the spirit of that order. I’m trying to learn more about whether this is just most of the grant process or all of it. And I’m trying to learn more about what people involved in this process are hearing about the duration of delays and at least the notional/purported reasons for them etc. I want to get down to the nitty gritty of what’s happening. So if you’re involved in NIH or other medical grant making and disbursal process on either end please reach out to me, either by the normal channels or by the encrypted channels I list above.
